| NPI | 1689632127 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: WA MD60872008) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: KS 0430797) |
| Enumeration Date | 2006-05-03 |
| Last Update Date | 2019-01-09 |